Prevalence and Factors Associated with Current Cigarette Smoking among Ethiopian University Students: A Systematic Review and Meta-Analysis

Abstract

Background. Although tobacco use is highest in high-income countries, most tobacco-related deaths occur in low- and middle-income countries with the highest number of deaths recorded in East Africa. The aim of this systematic review and meta-analysis is to determine the pooled prevalence and associated factors of current cigarette smoking among Ethiopian university students. Methods. The authors searched databases from PubMed, PsycINFO, Google Scholar, EMBASE, and Web of Sciences. The publications included in the analysis were inclusive, the literature was searched from January 2011 to December 2018. The JBI-MAStARI critical appraisal tool was applied to 13 publications identified by the database search. I2 statistics were used to indicate heterogeneity. Publication bias was evaluated using the visual funnel plot. A p value < 0.1 was considered as indicative of statistically significant publication bias. A random effect meta-analysis model was computed to estimate the pooled prevalence of cigarette smoking, and the variables associated with cigarette smoking were examined. Results. The meta-analysis of 13 studies showed that the pooled prevalence of current cigarette smoking was found to be 12.55% (95% CI: 10.39–14.72; I2 = 94.0%) with no publication bias according to Egger’s test (p=0.007) for cigarette smoking by 2.05 (95% CI: 1.52–2.75). Factors associated with cigarette smoking were peer influence 2.79 (95% CI: 1.62–4.82; I2 = 35.7), khat chewing (95% CI: 2.81–15.26; I2 = 82.5), and alcohol use 11.16 (95% CI: 7.46–16.71). Conclusion. Our findings indicate a high prevalence of cigarette smoking among Ethiopian university students as compared to the general population. Gender, peer influence, khat chewing, and current alcohol use were significantly associated with cigarette smoking. The authors recommend promoting antismoking campaigns, emphasizing health hazard public service announcements about cigarettes, and integrating health education on smoking in youth-friendly services, especially targeting higher educational institutions.

Prevalence of smoking and its associated factors among students of the University of Dongola, Northern State, Sudan: a cross-sectional study

“…The study found an overall smoking prevalence of 11.7%. These findings are consistent with previous studies; one conducted on medical students at National Ribat University, Khartoum, and another in Ethiopia, a neighbouring country 13 , 15 . However, the prevalence rate is significantly lower than those reported in China and Turkey 21 , 22 .…”

“…A study among Egyptian university students reported a smoking prevalence of 17.4% 12 . Similarly, a systematic review and meta-analysis in Ethiopia revealed a smoking prevalence of 12.55% among university students 13 . Locally, prevalence rates of tobacco use of 13.7% and smoking of 10% were recorded among university students from two studies in Khartoum, Sudan 14 , 15 .…”

Association between teachers’ outdoor smoking attitude and smoking initiation among in-school adolescents in Albania: A cross-sectional study

“…This prevalence is consistent with prior studies in Spain [26], Serbia [27], Indonesia [28], and India [29]. The prevalence is, however lower than what has been reported in prior studies among in-school adolescents including 34.1% in Bosnia and Herzegovina [30], 60% in Bangladesh [31], but still higher than that reported in earlier studies including 16.6% in Spain [32], 12.55% in Ethiopia [33], 6.8% in Zambia [34], and 17% in Indonesia [35]. The discrepancies in prevalence seen across these studies may be due to the underreporting of smoking by Albanian in-school adolescents because their teachers were present during data collection [2].…”

“…The discrepancies in prevalence seen across these studies may be due to the underreporting of smoking by Albanian in-school adolescents because their teachers were present during data collection [2]. The disparities could also be explained by the societal norms and values of the people, as well as by religious convictions and the fact that smoking is becoming more prevalent in low-and middle-income nations, including Albania [33,36].…”

Determinants of good academic performance among university students in Ethiopia: a cross-sectional study

“…For instance, in Australia, 69% of smokers attended bars, nightclubs, or gaming venues at least monthly [ 28 ] . Further, smokers are substantially engaged in khat chewing and alcohol drinking [ 29 ]. Having a serious health complication, wasting study hours, and concomitant substance use in college might prevent students from being able to perform their best in school.…”